Grief.com – Because LOVE Never Dies Five Stages of Grief by Elisabeth Kubler Ross & David Kessler Request a Lecture In our work, On Grief and Grieving Elisabeth Kubler-Ross and I wanted to revisit the stages for clarification in grief and loss. The stages have evolved since their introduction and they have been very misunderstood over the past three decades. They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss as there is no typical loss. Our grief is as individual as our lives. The five stages, denial, anger, bargaining, depression and acceptance are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief. Not everyone goes through all of them or in a prescribed order. Our hope is that with these stages comes the knowledge of grief ‘s terrain, making us better equipped to cope with life and loss. At times, people in grief will often report more stages. Just remember your grief is an unique as you are.

DENIAL Denial is the first of the five stages of grief. It helps us to survive the loss. In this stage, the world becomes meaningless and overwhelming. Life makes no sense. We are in a state of shock and denial. We go numb. We wonder how we can go on, if we can go on, why we should go on. We try to find a way to simply get through each day. Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief. There is a grace in denial. It is nature’s way of letting in only as much as we can handle. As you accept the reality of the loss and start to ask yourself questions, you are unknowingly beginning the healing process. You are becoming stronger, and the denial is beginning to fade. But as you proceed, all the feelings you were denying begin to surface. ANGERAnger is a necessary stage of the healing process. Be willing to feel your anger, even though it may seem endless. The more you truly feel it, the more it will begin to dissipate and the more you will heal.

There are many other emotions under the anger and you will get to them in time, but anger is the emotion we are most used to managing. The truth is that anger has no limits. It can extend not only to your friends, the doctors, your family, yourself and your loved one who died, but also to God. You may ask, “Where is God in this? Underneath anger is pain, your pain. It is natural to feel deserted and abandoned, but we live in a society that fears anger. Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss. At first grief feels like being lost at sea: no connection to anything. Then you get angry at someone, maybe a person who didn’t attend the funeral, maybe a person who isn’t around, maybe a person who is different now that your loved one has died. Suddenly you have a structure – – your anger toward them. The anger becomes a bridge over the open sea, a connection from you to them. It is something to hold onto; and a connection made from the strength of anger feels better than nothing.We usually know more about suppressing anger than feeling it. The anger is just another indication of the intensity of your love.

BARGAININGBefore a loss, it seems like you will do anything if only your loved one would be spared. “Please God, ” you bargain, “I will never be angry at my wife again if you’ll just let her live.” After a loss, bargaining may take the form of a temporary truce. “What if I devote the rest of my life to helping others. Then can I wake up and realize this has all been a bad dream?” We become lost in a maze of “If only…” or “What if…” statements. We want life returned to what is was; we want our loved one restored. We want to go back in time: find the tumor sooner, recognize the illness more quickly, stop the accident from happening…if only, if only, if only. Guilt is often bargaining’s companion. The “if onlys” cause us to find fault in ourselves and what we “think” we could have done differently. We may even bargain with the pain. We will do anything not to feel the pain of this loss. We remain in the past, trying to negotiate our way out of the hurt. People often think of the stages as lasting weeks or months.

They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. We do not enter and leave each individual stage in a linear fashion. We may feel one, then another and back again to the first one. Follow me on Facebook Tweets by @iamdavidkessler DEPRESSIONAfter bargaining, our attention moves squarely into the present. Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined. This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss. We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone? Why go on at all? Depression after a loss is too often seen as unnatural: a state to be fixed, something to snap out of. The first question to ask yourself is whether or not the situation you’re in is actually depressing. The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response. To not experience depression after a loved one dies would be unusual.

When a loss fully settles in your soul, the realization that your loved one didn’t get better this time and is not coming back is understandably depressing. If grief is a process of healing, then depression is one of the many necessary steps along the way. ACCEPTANCEAcceptance is often confused with the notion of being “all right” or “OK” with what has happened. This is not the case. Most people don’t ever feel OK or all right about the loss of a loved one. This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality. We will never like this reality or make it OK, but eventually we accept it. We learn to live with it. It is the new norm with which we must learn to live. We must try to live now in a world where our loved one is missing. In resisting this new norm, at first many people want to maintain life as it was before a loved one died. In time, through bits and pieces of acceptance, however, we see that we cannot maintain the past intact. It has been forever changed and we must readjust. We must learn to reorganize roles, re-assign them to others or take them on ourselves.

Finding acceptance may be just having more good days than bad ones. As we begin to live again and enjoy our life, we often feel that in doing so, we are betraying our loved one. We can never replace what has been lost, but we can make new connections, new meaningful relationships, new inter-dependencies. Instead of denying our feelings, we listen to our needs; we move, we change, we grow, we evolve. We may start to reach out to others and become involved in their lives. We invest in our friendships and in our relationship with ourselves. We begin to live again, but we cannot do so until we have given grief its time. The 5 Stages of Grief & Loss | Psych Central Home » Library » Grief & Loss » The 5 Stages of Grief & Loss The 5 Stages of Grief & Loss By Julie Axelrod ~ 4 min read The 5 stages of grief and loss are: 1. Denial and isolation; 2. Anger; 3. Bargaining; 4. Depression; 5. Acceptance. People who are grieving do not necessarily go through the stages in the same order or experience all of them.

The stages of grief and morning are universal and are experienced by people from all walks of life, across many cultures. Mourning occurs in response to an individual’s own terminal illness, the loss of a close relationship, or to the death of a valued being, human or animal. There are five stages of grief that were first proposed by Elisabeth Kübler-Ross in her 1969 book On Death and Dying. In our bereavement, we spend different lengths of time working through each step and express each stage with different levels of intensity. The five stages of loss do not necessarily occur in any specific order. We often move between stages before achieving a more peaceful acceptance of death. Many of us are not afforded the luxury of time required to achieve this final stage of grief. The death of your loved one might inspire you to evaluate your own feelings of mortality. Throughout each stage, a common thread of hope emerges: As long as there is life, there is hope. As long as there is hope, there is life. Many people do not experience the stages of grief in the order listed below, which is perfectly okay and normal.

The key to understanding the stages is not to feel like you must go through every one of them, in precise order. Instead, it’s more helpful to look at them as guides in the grieving process — it helps you understand and put into context where you are. All, keep in mind — all people grieve differently. Some people will wear their emotions on their sleeve and be outwardly emotional. Others will experience their grief more internally, and may not cry. You should try and not judge how a person experiences their grief, as each person will experience it differently. 1. Denial & Isolation The first reaction to learning about the terminal illness, loss, or death of a cherished loved one is to deny the reality of the situation. “This isn’t happening, this can’t be happening,” people often think. It is a normal reaction to rationalize overwhelming emotions. It is a defense mechanism that buffers the immediate shock of the loss. We block out the words and hide from the facts. This is a temporary response that carries us through the first wave of pain. 2. Anger As the masking effects of denial and isolation begin to wear, reality and its pain re-emerge. We are not ready.

The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family. Anger may be directed at our dying or deceased loved one. Rationally, we know the person is not to be blamed. Emotionally, however, we may resent the person for causing us pain or for leaving us. We feel guilty for being angry, and this makes us more angry. Remember, grieving is a personal process that has no time limit, nor one “right” way to do it. The doctor who diagnosed the illness and was unable to cure the disease might become a convenient target. Health professionals deal with death and dying every day. That does not make them immune to the suffering of their patients or to those who grieve for them. Do not hesitate to ask your doctor to give you extra time or to explain just once more the details of your loved one’s illness. Arrange a special appointment or ask that he telephone you at the end of his day. Ask for clear answers to your questions regarding medical diagnosis and treatment. Understand the options available to you. Take your time. 3. Bargaining The 5 Stages of Grief | Dr.

Christina Hibbert Dealing With Grief: The 5 Stages of Grief Dealing with grief is no easy task. As someone well-acquainted with death and loss, I know firsthand. Loss visits us all in one form or another, and where loss is, grief is sure to follow. But, take it from me—the only way to deal with grief is to really deal with grief. First, let’s just try to understand the grief process. As one expert has said, “Grief is the process that allows us to let go of that which was and be ready for that which is to come.” [i] That’s the purpose of grief work—it helps us move on. There are several models of grief that can provide a framework for what to expect and can help us “move on”. One of the most well-known models of is “The 5 Stages of Grief,” originally developed by the late (and great) Elizabeth Kubler-Ross. Most of us have heard of this model, but what do these stages really mean? Let’s take a look.

The 5 Stages of Grief Denial Acceptance The 5 Stages of Grief are not intended to be worked through and “checked off,” like a list. Rather, they are guideposts, helping us identify and understand what we may be feeling. Not everyone will experience every stage, and many people will go through the stages in a different order. In general, however, grief will include the following 5 phases. Denial: This stage includes feelings of shock, numbness, and disbelief. When loss first comes, most of us have a hard time believing “this is really happening.” It’s not that we‘re denying that the death or loss has actually occurred, but rather, it’s a sense of, “I just can’t believe this person I love isn’t going to walk through that door anymore.” Yet, the feelings of this stage also protect us. If we were to take in all the emotion related to the loss right away, it would be too overwhelming. Instead, our body and mind have a little time to adjust to the way things are now without the deceased.

Part of the “denial” stage is also to tell our story over and over—one of the best ways to deal with trauma, and also a way for us to make it real. Eventually, we may begin asking questions such as, “How did this happen,” or “Why?” This is a sign that we are moving out of the denial phase and into the feeling and healing process. Anger: Anger can present itself in a variety of ways—anger at your loved one, at others, at God, at the world, at yourself. And anger can be a difficult emotion to cope with. Some will express anger easily and toward anyone or anything, but many of us will suppress the anger instead, keeping it bottled up or even turning it inward, toward ourselves. Anger turned inward is guilt—guilt that we “should have done something,” or even guilt that we feel angry toward the deceased. But anger is a natural response to loss. And if we’re able to identify and label our anger, it can help us express it in healthier ways that don’t hurt others or ourselves. Saying, “I’m angry,” and letting yourself feel that anger is part of the healing process.

Bargaining With bargaining, there’s a sense that we just want life back to the way it used to be. We wish we could go back in time, catch the illness sooner, see something we didn’t see. We may also feel guilty, focusing on “If only…”. Bargaining can begin before the loss occurs or after. If the death or loss was anticipated, such as in the case of illness, bargaining may have been going on for a while—we bargain with God to please “spare” our loved one; we say we’ll “do anything” to keep them here. If the death or loss was sudden, we may wish we could bring them back or go back in time and change things. Bargaining keeps us focused on the past so we don’t have to feel the emotions of the present. But bargaining can be helpful too. Once we accept that our loved one is dying, we can use bargaining to ease our minds and theirs, praying for a “peaceful passing.” Or once they have passed, bargaining can help us focus on the future as we pray to “be reunited with them someday.” Depression Eventually grief will enter on a deeper level, bringing with it intense feelings of emptiness and sadness.

We feel like we don’t care about much of anything and wish life would just hurry up and pass on by. Getting out of bed can be a huge burden, exhaustion and apathy can set in, and we may begin to wonder, “what’s the point?” for pretty much everything. Others around us may try to help get us “out” of this “depression,” but it’s important to know that this isn’t a mental illness—it’s a natural response to loss. It’s not a clinical depression we’re experiencing, but rather bereavement and mourning, and the emotions of depression must be experienced in order to heal. We have to let ourselves feel the pain, loss, grief, and sadness, hard as it may seem. As Kubler-Ross encourages, “Make a place for your guest. Invite your depression to pull up a chair with you in front of the fire, and sit with it, without looking for a way to escape. Allow the sadness and emptiness to cleanse you and help you explore your loss in its entirety.” [ii] This part of the grief process can last for some time—there’s no set “time limit” for the emotions of grief.

So be patient with yourself, and remember that feeling the “depression” is the way out of it. Acceptance The experience of “depression” is what leads to “acceptance”. Many people mistakenly believe that “acceptance” means we are “cured” or “all right” with the loss. But this isn’t the case at all. The loss will forever be a part of us, though we will feel it more some times than others. Acceptance simply means we are ready to try and move on—to accommodate ourselves to this world without our loved one. This process can actually bring us closer to the one we loved as we make sense of how life was and process how we want life now to be. Understanding the 5 Stages of Grief can help us realize our grief is “normal” and help us navigate the varying symptoms we each experience. Mostly, however, understanding the 5 Stages of Grief can reassure us that we are not alone in our grief—that grief is one experience we will all have (or will have) in common. And that means, if we choose to, we have plenty of experienced souls to whom we can turn for support and guidance through our times of grief.

Cycle of Acceptance - Tool/Concept/Definition Home > Glossary > Cycle of Acceptance Cycle of Acceptance The Cycle of Acceptance is a predictable cycle most people and organizations go through upon receipt of very bad news, which includes an opinion that differs radically from one own. Entering the cycle is unavoidable. How long it takes a person or organization to complete the cycle is critical. The longer they're in it, the less likely they will ever fully complete the cycle and the less likely they will be able to deal with the problem wisely. The cycle looks like this: Click on the image for a PDF file for easier reading or printing. Why this is important Study the diagram closely. The key steps are denial, anger, depression, bargaining, and acceptance. These are easily memorized. Ask yourself, if my environmental organization suddenly found out it had been following the wrong problem solving process for decades, would that throw our organization into the Cycle of Acceptance, and thus into denial? Or might we go further and slip into the anger step, and shoot the messenger? It probably would, because that's exactly what's happened with the organizations I've worked with so far, as of May 2006.

(As of November 2011 when this article was last updated, the pattern is about the same, though a few organizations are showing signs of making it to the acceptance stage.) All have exhibited either denial and/or anger immediately. It is vitally important to recognize when one has entered the Cycle of Acceptance due to receipt of new information (such as an opinion or an alternative) that differs radically from your present one. There's no need to engage in denial, anger, and depression. One can objectively go immediately to the bargaining step. There you calmly weigh the new versus the old, and accept the new that's better and leave the old that's worse behind. Application example For example, here's what one respected environmental leader wrote to me in an email, after I posted a message on a document a forum group was discussing. The forum was moderated. My post was rejected. Here's what the leader said: “Hi Jack, We have been strongly urged by many participants to filter posts that take the discussion afield. I have concerns with your post (most trivially, that the link doesn't seem to be active). Your statement: 'The most basic premise in the article is the one that's never stated.

This premise assumes that if a realistic, well justified vision of a New Economy is presented to the right people and resolutions are passed, it will happen.' Not so and I don't know how you could make such inscriptions. Then, (name of forum) comments have to be more than redirecting the group to one's own (or someone else's) more enlightened and superior work. I respect your passion and energy, but perhaps (name of forum) is not right for you. This needs to be a collective endeavor by an extraordinary group that approaches the discourse constructively and humbly. All the best, (name).” Note the strong denial and the rationalization used to justify his position. My post included an attached document which analyzed the document the group was discussing. It presented clear, compelling reasons the implied premise was unsound. The link was to the paper on Change Resistance as the Crux of the Environmental Sustainability Problem . The link was working. But when a person is in a state of denial and anger, not everything works.

Note also the aggression in "more enlightened and superior work." As another example, here's what a mid-level manager of a major environmental organization had to say to me, after reading part one of the manuscript to Analytical Activism. The manager has an MBA and thus should perhaps not be so easily led astray: “I realize from your perspective that the environmental movement might look like a failure and our approaches irrational; however from my perspective it does not. It is a work in progress that I am delighted to participate in. There have been and continue to be many successes, some small and some major. Because you are working outside of the movement and are at home, you do not see the progress. You see the failures because they are more widely reported.” This is denial. Here's what the CEO of the same organization, which has over 300 employees, wrote me, after reading the same material: “…an organization like the [name of organization] is unlikely to embrace an entire new approach at once, however valid. I think you and your colleagues will feel less frustrated, and will make more rapid progress, if you seek to influence the ongoing dialogues on various issues within the [name of organization] as well as offering your own entirely new approach.

…this is an organization that often responds better to a series of coordinated, incremental nudges than to a big, bold, new idea.” However carefully worded this may be, it is also denial. But it gets worse. The same person, after the majority of their members' delegates voted for "a new way of thinking" at a national convention, wrote me: “I guess I really couldn't tell you what the vote for a new way of thinking meant -- it came out of the blue for me and was not expected. But I do think it indicates that people are open to new approaches -- but I did hear from several people that your proposal struck them as overly complex and difficult to implement in a grass-roots organization so you may want to try to create a much simpler presentation -- you may be losing people in the details.” Step 3: Denial - This is more denial. The executive is clearly rejecting the new way of thinking that his own organization wants and the new approaches I have offered as well. In both passages, he justifies his position with a rationalization.

In the first passage it is that I am not following proper channels or "ongoing dialogues." In the second passage the rationalization is that my "proposal" is "overly complex and difficult to implement." Neither is true, because as an experienced business consultant I have seen a completely different reaction from business managers to similar documents and face to face discussions of mine. Their reaction to the bad news of a poor assessment, presented with alternatives on how to improve, was to eagerly accept the bad news and move right into discussing how to best pursue the alternatives to improvement. Step 4: Anger - And then there is anger. The day one mid level environmental organization manager (who was also a professor at Yale University) read an analysis of mine that pointed out that organization was failing to achieve its objectives and offered a better way, that person called me up and proceeded to scold me for about 40 minutes. In their opinion, I didn't know enough about their organization to say what I said, and I should not say it anyhow, because it had not been agreed upon by them, and they've been having problems and are aware of them, and how do you get volunteers to do anything anyhow, and so on.

They were so angry the phone just about melted in my hand. Whenever I tried to say anything, I was quickly interrupted. I've never had a call like this before, so we have definitely touched a raw nerve. But this is a known phenomenon. It is the anger stage of the Cycle of Acceptance. Anger directed toward the bearer of bad news is known as shooting the messenger , which is a type of ad hominem argument. Step 5: Depression - The depression step for organizations is similar to depression for people, who withdraw into their own world. This is similar to the way some organizations start to keep as much as possible secret, or do lots of work internally and little externally, so as to avoid confrontation and criticism, and to create a sense of importance and self-worth. There is a lot of dysfunctional behavior associated with depression in people and organizations. It takes many forms. Basically it seems to be avoidance of the truth, so that the truth is less painful. Step 6: Bargaining - In the bargaining step an organization starts to question itself, such as: "Maybe this bad news has some truth to it, don't you think? What might happen if it was true?

I don't think we should be embarrassed that we failed in the past. It was a tough problem. But you know, I would be even more embarrassed if we failed to see that maybe this bad news is in some way good news. For example, this assessment that shows why we have done such a poor job for the last several decades seems to have a few valid points. It's not all wrong. I think that maybe we should at least take a look at some of the things in it that may be true." Step 7: Acceptance - Bargaining leads to the acceptance step. Basically, acceptance in the business world means admitting that you made a mistake or an undesirable situation is not going to go away, or both. Extremely mature managers and organizations arrive at the acceptance step almost instantly by skipping the other steps, because they are such a waste of time and energy. You can too, once you know the Cycle of Acceptance for what it is. Only after bad news is fully accepted can an organization begin to deal effectively with how to best adapt to change. After reading the material on Thwink.org, where are you and your organization in the Cycle of Acceptance?

Browse the Glossary Grief & Depression Coping With Denial, Loss, Anger and More What Can I Do if My Grief Won't Go Away? When you lose someone or something dear to you, it's natural to feel pain and grief . The grief process is normal, and most people go through it. But when grief takes over your life and you begin to feel hopeless, helpless, and worthless, then it's time to talk to your doctor about telling the difference between normal grief and depression . What Is Grief? Grief is a natural response to death or loss. The grieving process is an opportunity to appropriately mourn a loss and then heal. The process is helped when you acknowledge grief, find support, and allow time for grief to work. Each year, between 5% and 9% of the population loses a close family member. But that's not the only kind of loss that can cause grief.

People can feel loss when: They become separated from a loved one They lose a job, position, or income A pet dies or runs away Kids leave home They have a major change in life such as getting a divorce , moving, or retiring While we all feel grief and loss, and each of us is unique in the ways we cope with our feelings. Some people have healthy coping skills. They're able to feel grief without losing sight of their daily responsibilities. Other people don't have the coping skills or support they need. That hinders the grieving process. How Do We React to Grief and Loss? There are specific stages of grief. They reflect common reactions people have as they try to make sense of a loss. An important part of the healing process is feeling and accepting the emotions that come as a result of the loss. People go through common stages of grief: Denial, numbness, and shock: Numbness is a normal reaction to a death or loss and should never be confused with "not caring." This stage of grief helps protect us from experiencing the intensity of the loss. It can be useful when we have to take some action, such as planning a funeral, notifying relatives, or reviewing important papers.

As we move through the experience and slowly acknowledges its impact, the initial denial and disbelief fades. Continued Bargaining: This stage of grief may be marked by persistent thoughts about what "could have been done" to prevent the death or loss. Some people become obsessed with thinking about specific ways things could have been done differently to save the person's life or prevent the loss. If this stage of grief isn't dealt with and resolved, the person may live with intense feelings of guilt or anger that can interfere with the healing process. Depression : In this stage, we begin to realize and feel the true extent of the death or loss. Common signs of depression in this stage include trouble sleeping , poor appetite, fatigue , lack of energy, and crying spells. We may also have self-pity and feel lonely, isolated, empty, lost, and anxious. Anger: This stage is common. It usually happens when we feel helpless and powerless. Anger can stem from a feeling of abandonment because of a death or loss. Sometimes we're angry at a higher power, at the doctors who cared for a lost loved one, or toward life in general.

Acceptance: In time, we can come to terms with all the emotions and feelings we experienced when the death or loss happened. Healing can begin once the loss becomes integrated into our set of life experiences. Throughout our lives, we may return to some of the earlier stages of grief, such as depression or anger. Because there are no rules or time limit to the grieving process, everyone's healing process will be different. What Can Get in the Way of the Healing Process? Some things can impede or slow down the healing process following a death or loss. They include: Avoiding emotions The Kubler-Ross Grief Cycle The Kubler-Ross Grief Cycle Background For many years, people with terminal illnesses were an embarrassment for doctors. Someone who could not be cured was evidence of the doctors' fallibility, and as a result the doctors regularly shunned the dying with the excuse that there was nothing more that could be done (and that there was plenty of other demand on the doctors' time). Elizabeth Kubler-Ross was a doctor in Switzerland who was very unhappy about this unkindness and spent a lot of time with dying people, both comforting and studying them.

She wrote a book, called 'On Death and Dying' which included a cycle of emotional states that is often referred to (but not exclusively called) the Grief Cycle. In the ensuing years, it was noticed that this emotional cycle was not exclusive just to the terminally ill, but also other people who were affected by bad news, such as losing their jobs or otherwise being negatively affected by change. The important factor is not that the change is good or bad, but that they perceive it as a significantly negative event. The Extended Grief Cycle The Extended Grief Cycle can be shown as in the chart below, indicating the roller-coaster ride of activity and passivity as the person wriggles and turns in their desperate efforts to avoid the change. The initial state before the cycle is received is stable, at least in terms of the subsequent reaction on hearing the bad news. Compared with the ups and downs to come, even if there is some variation, this is indeed a stable state. And then, into the calm of this relative paradise, a bombshell bursts... Shock stage *: Initial paralysis at hearing the bad news. Denial stage : Trying to avoid the inevitable. Anger stage : Frustrated outpouring of bottled-up emotion.

Bargaining stage : Seeking in vain for a way out. Depression stage : Final realization of the inevitable. Testing stage *: Seeking realistic solutions. Acceptance stage : Finally finding the way forward. * This model is extended slightly from the original Kubler-Ross model, which does not explicitly include the Shock and Testing stages. These stages however are often useful to understand and facilitating change. Sticking and cycling Getting stuck A common problem with the above cycle is that people get stuck in one phase. Thus a person may become stuck in denial, never moving on from the position of not accepting the inevitable future. When it happens, they still keep on denying it, such as the person who has lost their job still going into the city only to sit on a park bench all day. Getting stuck in denial is common in 'cool' cultures (such as in Britain, particularly Southern England) where expressing anger is not acceptable. The person may feel that anger, but may then repress it, bottling it up inside. Likewise, a person may be stuck in permanent anger (which is itself a form of flight from reality) or repeated bargaining.

It is more difficult to get stuck in active states than in passivity, and getting stuck in depression is perhaps a more common ailment. Going in cycles Another trap is that when a person moves on to the next phase, they have not completed an earlier phase and so move backwards in cyclic loops that repeat previous emotion and actions. Thus, for example, a person that finds bargaining not to be working, may go back into anger or denial. Cycling is itself a form of avoidance of the inevitable, and going backwards in time may seem to be a way of extending the time before the perceived bad thing happens. Definition of DABDA: The Five Stages of Coping With Death D - Depression A - Acceptance The five stages of the Kübler-Ross stage model are the best-known description of the emotional and psychological responses that many people experience when faced with a life-threatening illness or life-changing situation. These stages don't only apply to loss as a result of death but may also occur in someone who experience a different life-changing event such as a divorce or loss of a job. These stages are not meant to be complete or chronological.

Not everyone who experiences a life-threatening or life-changing event feels all five of the responses nor will everyone who does experience them do so in the order that is written. Reactions to illness, death, and loss are as unique as the person experiencing them. In her famous book On Death and Dying, Kubler-Ross discusses this theory of coping in a linear fashion, meaning a person moves through one stage to reach the next. She later explained that the theory was never meant to be linear nor applied to all persons; the way a person moves through the stages is as unique as they are. It's important to remember that some people will experience all of the stages, some in order and some not, and other people may only experience a few of the stages or even get stuck in one. It's also interesting to note that the way a person has handled adversity in the past will affect how a diagnosis of terminal illness is handled. For example, a woman who always avoided adversity and used denial to cope with tragedy in the past may find herself stuck in the denial stage of coping for a long time. Similarly, a man who uses anger to deal with difficult situations may find himself unable to move out of the anger stage of coping.

Denial - Stage 1 We all want to believe that nothing bad can happen to us. Subconsciously, we might even believe we are immortal. When a person is given the diagnosis of a terminal illness, it's natural to enter a stage of denial and isolation. He may flat-out disbelieve what the doctor is telling him and seek out second and third opinions. He may demand a new set of tests, believing the results of the first ones to be false. Some people may even isolate themselves from their doctors and refuse to undergo any further medical treatment for a time. During this stage, one might also isolate himself from his family and friends to avoid discussions about his illness. He may believe on some level that by not acknowledging the diagnosis it will cease to exist. This stage of denial is usually short-lived. Soon after entering it, many begin to accept their diagnosis as reality. The patient may come out of isolation and resume medical treatment. Some people, however, will use denial as a coping mechanism long into their illness and even to their death. Extended denial isn't always a bad thing; it doesn't always bring increased distress. Sometimes we mistakenly believe that people need to find a way to accept their death to be able to die peacefully.

Those of us who have seen people maintain denial until the end know this isn't always true. Anger - Stage 2 As one accepts the reality of a terminal diagnosis, he may start to ask "Why me?" The realization that all of his hopes, dreams, and well-laid plans aren't going to come about brings anger and frustration. Unfortunately, this anger is often directed out at the world and at random. Doctors and nurses are yelled at in the hospital; family members are greeted with little enthusiasm and often suffer the random fits of rage. Even strangers aren't immune to the actions anger may bring about. It's important to understand where this anger is coming from. A dying person may watch TV and see people laughing and dancing -- a cruel reminder that he can't walk anymore, let alone dance. People caring for him in the hospital will eventually leave him to go home and continue on with their lives, while he remains in bed. In the book On Death and Dying, Kubler-Ross astutely describes this anger: "He will raise his voice, he will make demands, he will complain and ask to be given attention, perhaps as the last loud cry, 'I am alive, don't forget that.

You can hear my voice, I am not dead yet!'" For most people, this stage of coping is also short-lived. Again, however, some people will continue in anger for much of the illness. Some will even die angry. Bargaining - Stage 3 When denial and anger don't have the intended outcome, in this case a mistaken diagnosis or miracle cure, many people will move on to bargaining. Most of us have already tried bargaining at some point in our lives. Children learn from an early age that getting angry with Mom when she says "no" doesn't work, but trying a different approach might. Just like the child who has time to rethink his anger and begin the process of bargaining with a parent, so do many people with a terminal illness. Most people who enter the bargaining stage do so with their God. They may agree to live a good life, help the needy, never lie again, or any number of "good" things if their higher power will only cure them of their illness. Other people may bargain with doctors or with the illness itself.

They may try to negotiate more time saying things like, "If I can just live long enough to see my daughter get married..." or "If only I could ride my motorcycle one more time..." The implied return favor is that they would not ask for anything more if only their wish was granted. People who enter this stage quickly learn that bargaining doesn't work and inevitably move on, usually to the depression stage. Depression - Stage 4 When it becomes clear that the terminal illness is here to stay, many people experience depression. The increased burden of surgeries, treatments, and physical symptoms of illness -- for example -- make it difficult for some people to remain angry or to force a stoic smile. Depression, in turn, may creep in. Kubler-Ross explains that there are really two types of depression in this stage. The first depression, which she called "reactive depression," occurs as a reaction to current and past losses. For example, a woman who is diagnosed with cervical cancer may first lose her uterus to surgery and her hair to chemotherapy. Her husband is left without help to care for their three children, while she is ill and has to send the children to a family member out of town.

Because cancer treatment was so expensive, this woman and her spouse can't afford their mortgage and need to sell their home. The woman feels a deep sense of loss with each one of these events and slips into depression. The second type of depression is dubbed "preparatory depression." This is the stage where one has to deal with the impending future loss of everything and everyone they love. Most people will spend this time of grieving in quiet thought as they prepare themselves for such complete loss. This stage of depression is an important one to go through. It's a period of grieving that is essential for the dying person to cope with his death. If he is able to grieve fully and move through depression, the stage of acceptance will follow. Acceptance - Stage 5 The stage of acceptance is where most people would like to be when they die. It is a stage of peaceful resolution that death will occur and quiet expectation of its arrival. If one is lucky enough to reach this stage, his death is often very peaceful. He has had permission to express his fear, anger, and sadness. He has had time to make amends and say goodbye to those he loves.

He's also had time to grieve the loss of so many important people and things that mean so much to him. Some people who are diagnosed late in their illness and don't have time to work through these important stages may never experience true acceptance. Others who can't move on from another stage -- the man who stays angry at the world until his death, for example -- may also never experience the peace of acceptance. For the lucky one who does come to acceptance, the final stage before death is often spent in quiet contemplation as he turns inward to prepare for his final departure. Sources: Kübler-Ross, E. On Death and Dying. 1969. New York, NY: Scribner Publishers. DABDA. Urban Slang Dictionary. Available at: Continue Reading What's your grief? What's Your Question? Five Things You Should Know About the ‘Five Stages of Grief’ Pour yourself a heavily caffeinated beverage and settle in because today were going to talk about grief theory. Just when you thought we were almost out of interesting topics.

Once upon a time (1969) a psychiatrist name Elisabeth Kubler Ross wrote the book ‘On Death and Dying’ which introduced the world to the five stages of grief – denial, anger, bargaining, depression, acceptance. The five stages of grief are at the basis of the ‘Kubler-Ross Model’, a theory based on Kubler-Ross’s experience and interviews with terminally ill patients. Originally this model was applied to those facing the reality of their own death (the aforementioned terminally ill patients), but before long practitioners found the constructs of this neat and tidy model fit nicely with the analysis and treatment of grieving individuals. Since their introduction, the five stages of grief have become about as popular as any grief theory could ever hope, and they can be found in the mainstream media applied to anything from divorce to global markets. Despite the fact that the stages are often refuted in academia, the ‘Kubler-Ross Model’ seems to be the grief model for the masses. It’s intuitive, easy to grasp, and easy to prescribe. And prescribed it is – by that old guy at the church coffee hour, Aunt Barb, and Jimmy who lives down the street.

In fact you may be here by way of a Google search prompted by your Aunt Barb who told you you’re stuck in the ‘Anger Stage’ (which only made you angrier). Thanks Aunt Barb! I should probably tell you, if you’re waiting for me to explain the five stages I’m not going to. I f you want a better understand of the five stages of grief you should go to David Kessler’s website grief.com. He and Elisabeth Kubler-Ross co-authored the book On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss. I’m fairly sure he can explain it a lot better than me. You may be asking your computer screen, “then what the heck is this post about?” Well, I figure you’ve already heard about the model and many of you have already intuited how it should be applied. This happens all the time and unfortunately many people get it wrong and end up feeling confused and abnormal because their grief doesn’t follow the pattern. Before you decide that grief has literally made you crazy, there are a few things I think you should know. 1.

It is just a theory: There are many (many, many) grief theories; we just happen to hear about the five stages of grief so often those unfamiliar with grief models (i.e. pretty much everyone) tend to believe it’s the gold standard. The five stages of grief are not absolute truth. Like all theory, it’s based on a hypothesis (an educated guess). There is a bit of research to support the theory, but there is also a bit of research to contradict the theory. In reality, other grief models may fit your experience exponentially better than the ‘Kubler-Ross Model’. We plan to explain other grief models over the next few weeks (yay, it’s a series) so if you want exposure to alternative ways to interpret your experience, follow along. At the end of the day, you may take the stages or leave them. Just please (please, please) don’t expect your grief to fall into a neat and easy pattern, formula, or timeline, and don’t think you’re abnormal or crazy if your grief doesn’t transition through the stages in an orderly fashion. It just doesn’t work that way. 2. It is not linear:

Question: What's missing: Denial, Anger, Depression, Acceptance
Answer: Bargaining